HomeMy WebLinkAboutX2017-4069 - Misc1( 114 V jCk tlry t F -r A XUa i -ki
engineering DAY DATE r
® Seotechnical PROJECT NAME PROJECT NO.
applications LOCATION CITY
consultants
SUPERINTENDENT/FOREPERSON
FIELD REPORTCONTRACTORS)
TO: File
EQUIPMENT ON SITE
PERSONNEL ON SITE
TYPE OFI Q Soils U Structural Steel Assembly U Quality Control
INSPECTION Q Reinforced Concrete Q Drainage Q Epoxy
REQUIRED U Reinforced Masonry U Asphalt U Other
SUMMARY OF OBSERVATIONS AND/OR DISCUSSIONS:
TESTS PERFORMED: CYLINDERS:
RECOMMENDATIONS:
SIGNATURE, TITLE (POSITION)
PERSONNEL ON SITE ARRIVAL DEPARTURE TIME ON TRAVEL SUBTOTAL
SITE TIME SIGNATURE OF SUPERINTENDENT, TITLE (POSITION).
EGA CONSULTANTS
Jam/ 375-CMonte Vista Avenue
Costa Mesa, CA 92627
TOTAL HRS (949)642-9309
(4 HR. MIN.) FAX (949) 642-1290
I
DEPUTY 1 INSPECTION
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1-800-DEPUTYI
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CITY OF NEWPORT BEACH sub Contr z . , :r
COMMUNITY DEVELOPMENT DEPARTMENT
> BUILDING DIVISION
c` 41roR��A 100 Civic Center Drive.I P.O. Box 1768 1 Newport Beach, CA 92658
www.newoortbeachca aov 1(949)644-3200
SPECIAL INSPECTION REPORT p
Project Address: a`�ssN:
Permit Number n'. r7,7
Inspection Type (s):
Inspection Date (s): HJ ,if i P' ( ) Periodic ( .)Continuous
(0
List Tests Made: -
(I` I�C3,C ii l,u i 11 riffs` (�c i 1
r I
Total Inspection Time Each Day: ;.
Date
Hours: .. .... .....
...
:.List All Items Requiring Correction (include Previously Listed Uncorrected items):
To the best of my knowledge, the work inspected was in accordance with the Building Division approved design drawings,
specifications and applicable workmanship provisions of the U.B.C. except as noted above.
-
Special i spectorSignature: Date:.
i
i
Print Full Name:- Newport Beach Registration No.:
j )
SpeciallnspecbonReport 8-24-15
)(Z11_;10 '9
104 Yi a orv;da
CITY OF NEWPORT BEACH
COMMUNITY DEVELOPMENT DEPARTMENT
BUILDING DIVISION
100 Civic Center Drive I P.O. Box 17681 Newport Beach, CA 92658-8915
www.newportbeachca.gov 1 (949) 644-3200
SMOKE DETECTOR AND CARBON MONOXIDE
SELF -CERTIFICATION
(this certification is to be filled out by the permittee or homeowner)
Project Address: 104 Via Orvieto, Newport Beach
Permit Number: x2017-4069
Property Owner: Paul & Annie Kim
Licensed Contractor. Burkhart Brothers Construction
Llc #: 905510
The State of California now requires that smoke and carbon monoxide detectors must be
installed in all residential buildings
California Residential Code (CRC) Section R314.1, CRC R315.2 states in part that
existing dwellings be "retrofitted with smoke detectors and carbon monoxide detectors.
CRC Section R314.3, CRC R315.3 defines required locations.
Both boxes below must be checked.
61❑ Carbon Monoxide Alarm: On the ceiling or wall outside of each separate
sleeping area in the immediate vicinity of bedrooms or in each hallway outside of
the rooms, and each level of the dwelling. Detectors are also required in
bedrooms with gas fired appliances
23 ❑ Smoke Alarms: Installed in each room used for sleeping purposes, outside
each sleeping area, and on each level of the dwelling unit.
Retrofitted detectors may be battery operated for buildings where no alterations are
performed on the interior. Multiple -purpose alarms (carbon monoxide and smoke alarms)
shall comply with all applicable standards and must be approved by the State Fire
Marshall. The devices must be installed per manufacturer's specifications.
I, the undersigned, hereby certify that I am the permittee or homeowner of the
project. I further certify that smoke alarms and carbon monoxide alarms are
present and tested to be functional in all the following locations:
Signature: lwk 964J& Date:
12/4/2016
NOTE. This self -certification is only used for projects to the exterior of the structure where access to the
interior of the dwelling by the City of Newport Beach Building Inspector is not achieved during the course of
construction.
FormsVSmokeDetectomndCarbonMono)ddeSelfCert 06112M6
CITY OF NEWPORT BEACH
Community Development Department I Building Division
100 Civic Center Dr.1 P.O. Box 1768 1 Newport Beach, CA 92658
www.newportbeachca.aov 1(949)644-3200
CALGREEN DOCUMENTATION COMPLIANCE CERTIFICATION
ADDRESS: 104 Via Orvieto Newport Beach, CA PERMIT NO.: X2017-4069
THIS FORM SHALL BE COMPLETED AND SIGNED PRIOR TO REQUEST FOR FINAL BUILDING
INSPECTION. ONE COPY OF THIS FORM SHALL BE SUBMITTED TO THE BUILDING INSPECTOR AT
FINAL INSPECTION AND ONE SHALL BE PROVIDED TO THE BUILDING OWNER AS PART OF THE CAL
GREEN CERTIFICATION PACKAGE.
The following section shall be completed by a person with overall responsibility for the planning and
design portion of the project.
REQUIRED DOCUMENTATIONS PROVIDED TO THE PROPERTY OWNER(S)
Franchise Hauler for Construction/Demolition Waste (65% min. reuse of nonhazardous waste)
VOC Contents Limitation
Formaldehyde Emissions Limitation
t� T-24 Energy Certificate of Installations (Env., QII, Lighting, Photovoltaic, Mach., Plumb.)
Cvf T-24 Energy Certificate of Verifications or Acceptance ( Env., QII, Lighting, Photovoltaic, Mech.,
Plumb., HERS)
Pf Operations and Maintenance Manual
MOISTURE CONTENT OF BUILDING MATERIAL (RESIDENTIAL CONSTRUCTION ONLY)
I certify that the moisture content of the wall and floor framing is less than 19 percent as
determined in accordance with Section 4.505.3 of CAL Green prior to being enclosed.
DECLARATION STATEMENT
• 1 certify under penalty of perjury, under the laws of the State of California, the information
provided is true and correct.
• I certify that the installed measures, materials, components, or manufactured devices identified
on this certificate conform to all applicable codes and regulations, and the installation is
consistent with the plans and specifications approved by the enforcing agency.
Responsible Person's Name: Responsible Person's Signature:
Sarah Zimprich 1"ok 0'
Date Signed: Position/Title:
12/4/2018 Project Manager
Forms\CALGreen Documentation Compliance Cert Form 1-2017
CITY OF NEWPORT BEACH X1ril-40Eq
Community Development Department I Building Division ION V/G orv;E�6
100 Civic Center Dr.[ P.O. Box 1768 1 Newport Beach, CA 92658
www.newportbeachca.gov i (949) 644-3200
CALGREEN DOCUMENTATION COMPLIANCE CERTIFICATION
ADDRESS: 104 Via Orvieto Newport Beach, CA PERMIT NO.: x2017-4069
THIS FORM SHALL BE COMPLETED AND SIGNED PRIOR TO REQUEST FOR FINAL BUILDING
INSPECTION. ONE COPY OF THIS FORM SHALL BE SUBMITTED TO THE BUILDING INSPECTOR AT
FINAL INSPECTION AND ONE SHALL BE PROVIDED TO THE BUILDING OWNER AS PART OF THE CAL
GREEN CERTIFICATION PACKAGE.
The following section shall be completed by a person with overall responsibility for the planning and
design portion of the project.
REQUIRED DOCUMENTATIONS PROVIDED TO THE PROPERTY OWNER(S)
Franchise Hauler for Construction/Demolition Waste (65% min. reuse of nonhazardous waste)
6� VOC Contents Limitation
I( Formaldehyde Emissions Limitation
e T-24 Energy Certificate of Installations (Env., QII, Lighting, Photovoltaic, Mech., Plumb.)
N( T-24 Energy Certificate of Verifications or Acceptance ( Env., QII, Lighting, Photovoltaic, Mech.,
Plumb., HERS)
V Operations and Maintenance Manual
MOISTURE CONTENT OF BUILDING MATERIAL (RESIDENTIAL CONSTRUCTION ONLY)
6� 1 certify that the moisture content of the wall and floor framing is less than 19 percent as
determined in accordance with Section 4.505.3 of CAL Green prior to being enclosed.
DECLARATION STATEMENT
•
[certify under penalty of perjury, under the laws of the State of California, the information
provided is true and correct.
• 1 certify that the installed measures, materials, components, or manufactured devices identified
on this certificate conform to all applicable codes and regulations, and the installation is
consistent with the plans and specifications approved by the enforcing agency.
Sarah Zimpnch
Date
12/4/2018
rormsNcNwreen uocumencanon compliance cert Form 1-ZU17
Position/Title:
Project Manager
AA r_4osq
109 via, 0,we,lp
CITY OF NEWPORT BEACH
COMMUNITY DEVELOPMENT DEPARTMENT
BUILDING DIVISION
100 Civic Center Drive I P.O. Box 1768 1 Newport Beach, CA 92658-8915
www.newportbeachca.gov 1 (949) 644-3200
[Voluntary]
CONTRACTOR/PROPERTY OWNER SELF -CERTIFICATION DECLARATION
FOR RESIDENTIAL PROPERTIES
(Dishwasher, Garbage Disposal, Water Closet)
Project Address: 104 Via Orvieto, Newport Beach, CA
Date: 12/12/2018
Permit#: x201713069
The following is to be completed by the California licensed plumbing contractor or owner -builder, participating in
the City of Newport Beach Self -Certification Program. Please type or print.
Installer's Name: Burkhart Brothers Construction License No (if applicable) 905510
Installer's Mailing Address: 12 Balboa Coves Newport Beach, CA Phone # (required): 714.353.2272
Installer's EmaiLsarah@burkhartbros.com FAX#:
Installer
I certify that the installation is in compliance with applicable code requirements.
further affirm that I have reviewed and understand the requirements of the applicable 2013 California Plumbing Code
and Newport Beach Municipal Code and that all self -certification reports submitted will be based on the code
requirements contained therein.
Please check the appropriate box below for work to be completed under this Self -Certification declaration:
0 DISHWASHER. Installed same size and in the same location. Air gap fitting installed per
2013 California Plumbing Code, 807.4.
0 GARBAGE DISPOSAL. Installed same size and in the same location.
0 WATER CLOSET. Replaced in the same size and 1.28 gallon per flush.
' 12/12/2018
Installer's Signature Date
Property Owner (Required)
As the property owner of the project address noted above, I have read, understand and agree to participate in the
System Self-Certcation Program. I further understand that by participating in this program, the plumbing system will
not be inspected by a City of Newport Beach Building Inspector during construction or after installation unless
requested. The Building Division may request and reserves the right to verify code compliance after the installation is
com te. Q
oec
Propitty Owner's Signature Date
Print Name Email
This form must be completed and returned to the City of Newport Beach, Building Division, for a final approval
of the plumbing permit. Please return this form to the Building Division by mail or fax.
Please mail to: City of Newport Beach Phone: (949) 718-1888
Community Development Department Fax #: (949) 644-3250
Building Division
P. O. Box 1768
Newport Beach, CA 92658
Forms\Contractor-OwnerSelt-CertDeciaration-DishmsherOartageDispWalerCloset 06/11/16
CITY OF NEWPORT BEACH
COMMUNITY DEVELOPMENT DEPARTMENT
BUILDING DIVISION
100 Civic Center Drive I P.O. Box 1768 1 Newport Beach, CA 92658-8915
www.newportbeachca.gov 1 (949) 6443200
CONTRACTOR/PROPERTY OWNER SELF -CERTIFICATION DECLARATION
FOR PLUMBING FIXTURE REPLACEMENT
Project Address: 104 Via Orvieto, Newport Beach
Date: 12/12/2018
Permit #: x2017.4069
The following is to be completed by the California licensed contractor or owner, participating in the City of Newport
Beach Self -Certification Program. Please type or print.
Installer's Name: Burkhart Brothers Construction License No (if applicable) 905510
Installer's Mailing Address: 12 Balboa Coves Newport Beach, CA 92663 Phone # (required): 714.353.2272
Installer's Email: Sarah@burkhartbros.com FAX #
Installer
I certify that the installation is In compliance with applicable code requirements.
I further affirm that I have reviewed and understand the requirements of the applicable 2013 California Green Code and
Newport Beach Municipal Code (NBMC) Section 301.1.1 and that all self -certification reports submitted will be based
on the code requirements contained therein.
I declare that all plumbing fixtures subject to the NBMC 301.1.1 has been replaced meeting the low flow requirements:
Kitchen faucets: 1.5 gal/minute at 60 psi
Shower heads: 2.0 gal minute at 80 psi
Water closet: 1.28 gal/flush
Faucets: maximum flow rate of 1.5 gal/minute at 60 psi,
and minimum 0.8 gal/minute at 20 psi
12/12/2018
Installer's Signature
Date
Property Owner (Required)
As the property owner of the project address noted above, I have read, understand and agree to participate in the
Plumbing Fixture Replacement Self -Certification Program. I further understand that by participating in this program, the
plumbing system will not be inspected by a City of Newport Beach Building Inspector during construction or after
installation unless requested. The Building Division may request and reserves the right to verify code compliance after
the ipstlation is complete. -
Z � ` y p
(/ f� 16
Pmpery owners Signature Date
Print Name Email
This form must be completed and returned to the City of Newport Beach, Building Division, for a final approval
of the combination permit. Please return this form to the Building Division by mail or fax.
Please mail to: City of Newport Beach Phone: (949) 718-1888
Community Development Department Fax #: (949) 644-3250
Building Division
P. O. Box 1768
Newport Beach, CA 92658
FonnSIConirector-ownerSelf-CertOeclamflon-Plumbing Fixture Replacement 08111(16
CITY OF NEWPORT BEACH
COMMUNITY DEVELOPMENT DEPARTMENT
BUILDING DIVISION
100 Civic Center Drive I P.O. Box 1768 ) Newport Beach, CA 92658-8915
www.newportbeachca.gov ) (949) 644-3200
[Voluntary]
CONTRACTORIPROPERTY OWNER SELF -CERTIFICATION DECLARATION
FOR RESIDENTIAL PROPERTIES
(Dishwasher, Garbage Disposal, Water Closet)
Project Address: 104 Via Orvieto, Newport Beach, CA
Date: 12/12/2018 Permit #: x201714069
The following is to be completed by the California licensed plumbing contractor or owner -builder, participating in
the City of Newport Beach Self -Certification Program. Please type or print.
Installer's Name: Burkhart Brothers Construction License No (if applicable) 905510
Installer's Mailing Address: 12 Balboa Coves Newport Beach, CA Phone # (required): 714.353.2272
Installer's Email:sarah@burkhartbros.com FAX #:
Installer
I certify that the installation is in compliance with applicable code requirements.
I further affirm that I have reviewed and understand the requirements of the applicable 2013 California Plumbing Code
and Newport Beach Municipal Code and that all self -certification reports submitted will be based on the code
requirements contained therein.
Please check the appropriate box below for work to be completed under this Self -Certification declaration:
❑X DISHWASHER. Installed same size and in the same location. Air gap fitting installed per
2013 California Plumbing Code, 807.4.
10 GARBAGE DISPOSAL. Installed same size and in the same location.
❑X WATER CLOSET. Replaced in the same size and 1.28 gallon per flush
00444— 12/12/2018
Installer's Signature Date
Property Owner (Required)
As the property owner of the project address noted above, I have read, understand and agree to participate in the
System Seff-Certification Program. I further understand that by participating in this program, the plumbing system will
not be inspected by a City of Newport Beach Building Inspector during construction or after installation unless
requested. The Building Division may request and reserves the right to verify code compliance after the installation is
com ate.
(2 Oec
Prop y Owner's Signature Date
MA 6 e, C Vl
Print Name Email
This form must be completed and returned to the City of Newport Beach, Building Division, for a final approval
of the plumbing permit. Please return this form to the Building Division by mail or fax.
Please mail to: City of Newport Beach Phone: (949) 718-1888
Community Development Department Fax'#: (949) 644-3250
Building Division
P. O. Box 1768
Newport Beach, CA 92658
FonnslContractor-OvmerSelFCertDeclamtion-DishmsherearbageDispWaterCloset 08/11/16
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